Pediatric Language Therapy Asssociates PC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

PEDIATRIC LANGUAGE THERAPY ASSSOCIATES PC

Practice address

14207 E 14TH St
San Leandro, CA 94578-2709

Phone

(510) 542-9404

Fax

(510) 295-2446

NPI assigned

Oct 19, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Claire Ibrahim, MS, CCC-SLPNPI 1275028821

Title

Owner

Phone

(510) 816-8005

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• East Bay Child Development Center Doing business as

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Claire F Ibrahim, MS, CCC-SLP

  • Speech-Language Pathologist
  • Vallejo, CA
  • NPI 1275028821
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1666137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739145600000",
    "number": "1285350389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14207 E 14TH ST",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945782709",
            "telephone_number": "510-542-9404",
            "fax_number": "510-295-2446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14207 E 14TH ST",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945782709",
            "telephone_number": "510-542-9404",
            "fax_number": "510-295-2446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC LANGUAGE THERAPY ASSSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-19",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "CLAIRE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-816-8005",
        "authorized_official_credential": "MS, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1275028821",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "claire@eastbaycdc.com",
            "affiliation": "N",
            "address_1": "14207 E 14th St",
            "city": "San Leandro",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945782709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "East Bay Child Development Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Speech-Language Pathologist in San Leandro, CA
• Providers in San Leandro, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.